埃塞俄比亚两家转诊医院老年癫痫患者中潜在的不适当处方情况。
Potentially inappropriate prescribing in elderly patients with epilepsy at two referral hospitals in Ethiopia.
作者信息
Tadesse Tamrat Assefa, Belayneh Alemu, Aynalem Minychel Wale, Yifru Yared Mamushet, Amare Firehiwot, Beyene Dessale Abate
机构信息
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Pharmacy, All Africa Leprosy Tuberculosis and Rehabilitation Training Centre Hospital, Addis Ababa, Ethiopia.
出版信息
Front Med (Lausanne). 2024 Aug 29;11:1403546. doi: 10.3389/fmed.2024.1403546. eCollection 2024.
INTRODUCTION
The prevalence of drug therapy problems in patients with epilepsy has been reported to be as high as 70-90%. Moreover, elderly patients with epilepsy are highly vulnerable to inappropriate therapies. This study aimed to evaluate potentially inappropriate prescriptions (PIP) in elderly patients with epilepsy at the adult neurology clinics of two referral hospitals in Addis Ababa, Ethiopia.
METHODS
A cross-sectional study was conducted on 81 patients with epilepsy and the medication appropriateness index (MAI), the Beers, and Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to the Right Treatment (STOPP/START) criteria were used to assess PIP. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.
RESULTS
Of the 81 study participants, 41(50.6%) were male, and the mean age was 67.33 ± 17.43 years. One-fourth of the study participants (25.9%) had polypharmacy and drug-drug interactions (DDIs) were documented in 64 (79%) patients. Based on the MAI, of the 263 medications that were prescribed for elderly epileptic patients, 110 (41.8%) had drug interactions, 44 (16.7%) had inappropriate indications, 31 (11.8%) were ineffective, and 12 (4.6%) were prescribed incorrect doses. Based on the STOPP and START criteria, PIP was reported in 31(38.3%) and 13(16.1%) patients, respectively.
CONCLUSION
Polypharmacy and DDIs are common in elderly epilepsy patients. The MAI, Beer's criteria, and STOPP/START criteria indicate a high prevalence of PIP in elderly patients with epilepsy.
引言
据报道，癫痫患者中药物治疗问题的发生率高达70%-90%。此外，老年癫痫患者极易受到不适当治疗的影响。本研究旨在评估埃塞俄比亚亚的斯亚贝巴两家转诊医院成人神经科门诊老年癫痫患者中潜在的不适当处方（PIP）。
方法
对81例癫痫患者进行了横断面研究，并使用药物适宜性指数（MAI）、Beers标准、老年人处方筛查工具以及正确治疗警报筛查工具（STOPP/START）标准来评估PIP。使用社会科学统计软件包（SPSS）25版对数据进行分析。
结果
81名研究参与者中，41名（50.6%）为男性，平均年龄为67.33±17.43岁。四分之一的研究参与者（25.9%）使用了多种药物，64名（79%）患者记录到药物相互作用（DDI）。根据MAI，在为老年癫痫患者开具的263种药物中，110种（41.8%）存在药物相互作用，44种（16.7%）适应证不适当，31种（11.8%）无效，12种（4.6%）剂量开具错误。根据STOPP和START标准，分别有31名（38.3%）和13名（16.1%）患者报告存在PIP。
结论
多种药物联用和DDI在老年癫痫患者中很常见。MAI、Beer标准以及STOPP/START标准表明老年癫痫患者中PIP的发生率很高。
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